Hallucinatory experiences reported by children following an - PowerPoint PPT Presentation

Hallucinatory experiences reported by children following an intensive care admission Gillian Colville, Christine Pierce Great Ormond St Hospital, London

Sample (n=102/132) • Survivors over 7 years of age interviewed 3 months after discharge – 60 male, 42 female – Median child age 11.3yrs (7-17) – Median length of stay 2 days (0-38) Exclusions • Learning difficulties; readmitted to PICU; professional refusal (eg palliative care)

Psychological measures Child • ICU Memory Tool (factual v delusional memories) • Child Revised Impact of Event Scale (post traumatic stress)

Reason for admission med other trauma hi med neuro med resp trauma surg emerg surg planned

Memories 63% remembered some factual information about PICU

Delusional Memories • 1 in 3 children experienced hallucinations or unusually vivid dreams

Delusional memories v Midazolam (χ 2 p=0.10) 50% 40% 30% 20% 10% 0% none <48hrs 48hrs +

Delusional memories v Morphine (χ 2 p=0.001) 60% 50% 40% 30% 20% 10% 0% none <48hrs 48hrs +

Partial correlations Midazolam v Delusional Memories r = 0.20* controlling for morphine: r = - 0.16 ns

Partial correlations Morphine v Delusional Memories r = 0.37** controlling for midazolam: r = 0.35**

Content of Hallucinations Giant talking flower (+) Butterflies and clouds (+) Family members (inc deceased)

• “This isn’t my head!” “Where are my fingers?” • Rats in cups moving across the wall • Convinced ceiling was falling in • Hell • Terrorist attack

• All my friends jumping out of the window • Massive beehive • Loads of massive spiders – we had to throw stones at them • Scorpions everywhere • Men in a wood running after me – I had to run into the sunlight • A man who looked like my dad…a woman who looked like my mum • Loads of patterns – scary squiggly lines, orange on a black background • Scary People walking on the ceiling • Bad people took me away and were going to hurt my baby sister and throw her down a hole in the pub

Proportions of parents and children scoring above PTSD cut offs 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Parents Children

Associations with child PTSD score • Age NS • Sex NS • Length of stay NS • Elective v emergency p=0.01 • Parent’s PTSD score p=0.05 • Factual memories NS • Delusional memories p=0.01

Main findings • Significant minority of children recall hallucinations and bizarre dreams during hospital stay • Hallucinations associated with length of time on morphine but not midazolam • Children’s post traumatic stress at 3 months related to to presence of hallucinations and emergency admission, but not factual memory

Funded by The Health Foundation